Inmedicine,asurgeonis amedical doctorwho performssurgery.Even though there are different traditions in different times and places, a modern surgeon is a licensedphysicianand received the same medical training as physicians before specializing in surgery.
In some countries and jurisdictions, the title of 'surgeon' is restricted to maintain the integrity of the craft group in the medical profession. A specialist regarded as a legally recognized surgeon includespodiatry,dentistry,andveterinary medicine.It is estimated that surgeons perform over 300 million surgical procedures globally each year.[1][2]
History
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The first person to document a surgery was the 6th century BC Indian physician-surgeon,Sushruta.He specialized in cosmetic plastic surgery and even documented an openrhinoplastyprocedure.[3]Hismagnum opusSuśruta-saṃhitāis one of the most important surviving ancient treatises on medicine and is considered a foundational text of bothAyurvedaand surgery. The treatise addresses all aspects of general medicine, but the translator G. D. Singhal dubbed Sushruta "the father of surgical intervention" on account of the extraordinarily accurate and detailed accounts of surgery to be found in the work.[4]
After the eventual decline of the Sushruta School of Medicine in India, surgery was largely ignored until theIslamic Golden AgesurgeonAl-Zahrawi(936–1013) re-established surgery as an effective medical practice. He is considered the greatest medieval surgeon to have appeared from the Islamic World, and has also been described as thefather of surgery.[5]His greatest contribution to medicine is theKitab al-Tasrif,a thirty-volume encyclopedia of medical practices.[6]He was the first physician to describe anectopic pregnancy,and the first physician to identify the hereditary nature ofhaemophilia.[7]
His pioneering contributions to the field of surgical procedures and instruments had an enormous impact on surgery but it was not until the 18th century that surgery emerged as a distinct medical discipline in England.[7]
In Europe, surgery was mostly associated with barber-surgeons who also used their hair-cutting tools to undertake surgical procedures, often at the battlefield and also for their employers.[8]With advances in medicine and physiology, the professions of barbers and surgeons diverged; by the 19th century barber-surgeons had virtually disappeared, and surgeons were almost invariably qualified doctors who had specialized in surgery.Surgeoncontinued, however, to be used as the title for military medical officers until the end of the 19th century, and the title ofSurgeon Generalcontinues to exist for both senior military medical officers and senior government public health officers.
Titles in the Commonwealth
editIn 1950, theRoyal College of Surgeons of England(RCS) inLondonbegan to offer surgeons a formal status via RCS membership. The titleMisterbecame a badge of honour, and today, in manyCommonwealth countries,a qualified doctor who, after at least four years' training, obtains a surgical qualification (formerlyFellow of the Royal College of Surgeons,but now alsoMember of the Royal College of Surgeonsor a number of other diplomas) is given the honour of being allowed to revert to calling themselvesMr,Miss,MrsorMsin the course of their professional practice, but this time the meaning is different. It is sometimes assumed that the change of title impliesconsultantstatus (and some mistakenly think non-surgical consultants are Mr too), but the length of postgraduate medical training outside North America is such that a qualified surgeon may be years away from obtaining such a post: many doctors previously obtained these qualifications in the senior house officer grade, and remained in that grade when they began sub-specialty training. The distinction of Mr (etc.) is also used by surgeons in theRepublic of Ireland,some states ofAustralia,Barbados,New Zealand,South Africa,Zimbabwe,and some other Commonwealth countries.[9]In August 2021, the Royal Australasian College of Surgeons announced that it was advocating for this practice to be phased out and began encouraging the use of the gender neutral title Dr or appropriate academic titles such as Professor.[10]
Military titles
editIn many English-speaking countries themilitarytitle of surgeonis applied to any medical practitioner, due to the historical evolution of the term. TheUS Army Medical Corpsretains various surgeonUnited States military occupation codesin the ranks ofofficerpay grades, for military personnel dedicated to performing surgery on wounded soldiers.
Specialties
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- cardiothoracic surgery
- Colorectal surgery
- Craniofacial surgery
- Dental surgery
- Endocrine surgery
- General surgery
- Neurological surgery
- Obstetrics and gynaecology
- Ophthalmology
- Oral and maxillofacial surgery
- Orthopedic surgery
- Otorhinolaryngology
- Pediatric surgery
- Plastic surgery
- Podiatric surgery
- Surgical oncology
- Thoracic surgery(in the United States considered part ofcardiothoracic surgery)
- Transplant surgery
- Trauma surgery
- Upper gastrointestinal surgery
- Urology
- Vascular surgery
Some physicians who aregeneral practitionersor specialists infamily medicineoremergency medicinemay perform limited ranges of minor, common, or emergency surgery.Anesthesiaoften accompanies surgery, andanesthesiologistsandnurse anesthetistsmay oversee this aspect of surgery.Surgeon's assistant,surgical nurses,surgical technologistsare trained professionals who support surgeons.
In the United States, the Department of Labor description of a surgeon is "a physician who treats diseases, injuries, and deformities by invasive, minimally-invasive, or non-invasive surgical methods, such as using instruments, appliances, or by manual manipulation".[11]
Around the world, the array of 'surgical' pathology that a surgeon manages does not always require surgical methods. For example, surgeons treat diverticulitis conservatively using antibiotics and bowel rest. In some cases of small bowel obstruction, particularly where a patient has had previous abdominal surgery, the surgeon treats the patient with fluid resuscitation, nasogastric decompression of the stomach, which gives rise to resolution of the intestinal obstruction in cases where adhesions are the aetiology of the obstruction. The same is true for other craft groups in surgery.
Pioneer surgeons
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- Christiaan Barnard(cardiac surgery, firstheart transplantation)
- Alfred Blalock(first modern day successfulopen heart surgeryin 1944)
- Nina Starr Braunwald(First femalecardiac surgeon)
- Dorothy-Laviania Brown(First female African-American surgeon)
- Victor ChangAustralian pioneer of heart transplantation
- Harvey Cushing(pioneer, and often considered the father of, modernneurosurgery)
- Eleanor Davies-Colley(surgeon and founder of the South London Hospital for Women and Children)
- Michael DeBakey(educator and innovator in the field ofcardiac surgery)
- René Favaloro(first surgeon to performbypass surgery)
- Svyatoslav Fyodorov(creator ofradial keratotomy)
- Harold Gillies(pioneer of plastic surgery)
- Jesse Gray(First female chief of surgery at Hopkinz Hospital)
- William Stewart Halsted(initiated surgical residency training in U.S., pioneer in many fields)
- Michael R. Harrison(pioneer offetal surgery)
- SirVictor Horsley(neurosurgery)
- John Hunter(Scottish, viewed as the father of modern surgery, performed hundreds of dissections, served as the model forDr. Jekyll.)
- Gavriil Ilizarov,inventor of theIlizarov apparatusfor lengthening limb bones and for the method of surgery named after him, theIlizarov surgery
- Charles Kelman(Inventedphacoemulsification,the technique of modern cataract surgery)
- Lars Leksell(neurosurgery, inventor ofradiosurgery)
- C. Walton Lillehei(labeled "Father of modern dayopen heart surgery")
- Joseph Lister(discoverer of surgicalsepsis,[12]Listerinenamed in his honour[12])
- B. K. Misra– first neurosurgeon in the world to performimage-guided surgeryforaneurysms,first in South Asia to performstereotactic radiosurgery,first in India to performawake craniotomyandlaparoscopicspine surgery.[13]
- Ioannis Pallikaris(Greek surgeon. Performed the first LASIK procedure on ahuman eye.[14]DevelopedEpi-LASIK.[15])
- Fidel Pagés(pioneer ofepidural anesthesia)
- Wilder Penfield(neurosurgery)
- Gholam A. Peyman(inventor ofLASIK,[16])
- Nikolay Pirogov(the founder offield surgery)
- Jennie Simile Robertson(first female surgeon in Canada)
- Valery Shumakov(pioneer of artificial organs implantation)
- Maria Siemionow(pioneer of near-total face transplant surgery)
- Thomas E. Starzl(pioneer of the development of liver transplantations[17])
- Sushruta(the first to document an operation of openrhinoplasty[3])
- Paul Tessier(French surgeon inCraniofacial surgery)
- Mary Edwards Walker(first female surgeon in the United States)
- Gazi Yasargil(Turkishneurosurgeon,founder ofmicroneurosurgery)
- al-Zahrawi,regarded as one of the greatest medieval surgeons and a father of surgery.[18]
Organizations and fellowships
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References
edit- ^Weiser, Thomas G.; Haynes, Alex B.; Molina, George; Lipsitz, Stuart R.; Esquivel, Micaela M.; Uribe-Leitz, Tarsicio; Fu, Rui; Azad, Tej; Chao, Tiffany E.; Berry, William R.; Gawande, Atul A. (2015)."Estimate of the global volume of surgery in 2012: An assessment supporting improved health outcomes".The Lancet.385:S11.doi:10.1016/S0140-6736(15)60806-6.PMID26313057.S2CID24856780.
- ^Liu, Liang Qin; Mehigan, Sinead (2021)."A Systematic Review of Interventions Used to Enhance Implementation of and Compliance with the World Health Organization Surgical Safety Checklist in Adult Surgery"(PDF).AORN Journal.114(2): 159–170.doi:10.1002/aorn.13469.PMID34314014.S2CID236452617.Archived(PDF)from the original on 2023-02-28.Retrieved2023-02-28.
- ^abPapel, Ira D. and Frodel, John (2008)Facial Plastic and Reconstructive Surgery.Thieme Medical Pub.ISBN1588905152
- ^Singhal, G. D. (1972).Diagnostic considerations in ancient Indian surgery: (based on Nidāna-Sthāna of Suśruta Saṁhitā).Varanasi: Singhal Publications.
- ^Ahmad, Z. (St Thomas' Hospital) (2007), "Al-Zahrawi – The Father of Surgery",ANZ Journal of Surgery,77(Suppl. 1): A83,doi:10.1111/j.1445-2197.2007.04130_8.x,S2CID57308997
- ^al-Zahrāwī, Abū al-Qāsim Khalaf ibn ʻAbbās; Studies, Gustave E. von Grunebaum Center for Near Eastern (1973).Albucasis on surgery and instruments.University of California Press.ISBN978-0-520-01532-6.Retrieved16 May2011.
- ^abCosman, Madeleine Pelner; Jones, Linda Gale (2008).Handbook to Life in the Medieval World.Handbook to Life Series. Vol. 2.Infobase Publishing.pp. 528–530.ISBN978-0-8160-4887-8.
- ^"Surgeons and Surgical Spaces #The barbers shop".sciencemuseum.org.uk.Archivedfrom the original on 2020-08-07.Retrieved2020-05-05.
- ^"Patients: The Surgical Team: Qualifications of a surgeon".Royal College of Surgeons of England.Archivedfrom the original on 2 July 2015.Retrieved13 June2015.
- ^"RACS phases out gendered titles for surgeons".Royal Australasian College of Surgeons.Archivedfrom the original on 31 August 2021.Retrieved31 August2021.
- ^"Occupational Employment Statistic: Occupational Employment and Wages, May 2015: 29–1067 Surgeons".bls.gov.Archivedfrom the original on 2016-05-06.Retrieved2016-04-26.
- ^ab"Joseph Lister's antisepsis system | Science Museum".www.sciencemuseum.org.uk.Retrieved2024-04-28.
- ^Basant Kumar Misra, President NSI 2008Archived2021-02-27 at theWayback Machine.Neurological Society of India
- ^Stuart, Annie (1 June 2009)."A Look at LASIK Past, Present and Future".American Academy of Ophthalmology.Archivedfrom the original on 10 July 2016.Retrieved2 July2016.
- ^"When Cornea Transplants Fail. What Next?"Harvard University.Archived2006-09-09 at theWayback Machine
- ^Peyman, Gholam A. (1989)U.S. patent 4,840,175"Method for modifying corneal curvature".
- ^"The Transplanted Organs: The Liver".www.starzl.pitt.edu.
- ^Martín-Araguz, A.; Bustamante-Martínez, C.; Fernández-Armayor Ajo, V.; Moreno-Martínez, J. M. (2002). "Neuroscience in al Andalus and its influence on medieval scholastic medicine".Revista de Neurología.34(9): 877–892.doi:10.33588/rn.3409.2001382.PMID12134355.